Randomized Trial of Single-incision Midurethral Sling and Laparoscopic Burch Colposuspension: Postoperative Surgical Outcomes and Complications.

STUDY OBJECTIVE: Various retropubic and midurethral sling techniques have shown high cure rates in the treatment of stress urinary incontinence (SUI). This study aimed to compare single-incision midurethral sling (SIMS) and laparoscopic Burch colposuspension (LBC) procedures in patients with SUI in terms of the effectiveness, patient satisfaction, surgical complications and results. DESIGN: This is a prospective randomized study. SETTING: A university tertiary hospital. PATIENTS: Forty patients with clinically and/or urodynamically proven SUI who agreed to surgical treatment were randomized to the SIMS and LBC groups and included in the study. INTERVENTIONS: Patients were treated with SIMS and LBC operations. MEASUREMENTS AND MAIN RESULTS: Demographic characteristics of patients, physical and pelvic examination, preoperative and postoperative clinical findings, Kings Health Questionnaire form, Female Sexual Function Index and Prolapse Quality of Life Questionnaire form, postoperative day 1 visual analog scale score, and postoperative complications were recorded. Objective and subjective success rates were recorded by re-evaluating the patients in the first and sixth months of the operation. Objective success was defined as having a negative stress test and subjective success was defined as the absence of stress-induced urine leakage after surgery in a validated questionnaire. The primary result of our study was considered to be objective success, whereas the secondary result was subjective success and life quality tests. Twenty patients each in the SIMS group and the LBC group were included in the study. No significant difference was found in objective success (90% vs 85%, p = .633) or subjective success (85% vs 75%, p = .695) between the 2 groups at 6-month follow-up. A significant improvement in life quality was observed in the postoperative period for both groups; however, the difference between the groups was not significant. There was an improvement in sexual function in both groups. Nonetheless, although this improvement was significant in the SIMS group, it was not significant in the LBC group. In addition, surgery time, catheterization time, and hospitalization time were shorter in the SIMS group than in the LBC group. The visual analog scale score on postoperative day 1 was lower in the SIMS group. Groups were not different in terms of preoperative and postoperative complications. CONCLUSION: This preliminary study is the first randomized study that compares the LBC and SIMS procedures in the literature. It shows that SIMS and LBC procedures have not different objective and subjective success rates in the short term. It was also observed that they increase both sexual and life quality results in a positive and similar way.

Effects of the Kahramanmaras, Turkey 2023 earthquakes on balance perception, dizziness and post-traumatic stress: A relational screening model between subjective balance problems and post-traumatic stress.

OBJECTIVE: The aim of the present study was to investigate the effects of the February 6, 2023, earthquakes in Turkey and recurrent aftershocks on balance and post-traumatic stress in surviving victims. METHODS: Our study included 1004 participants aged 18-65 years who were exposed to the February 6 earthquakes and aftershocks in Turkey. After obtaining online consent from all participants, the Vertigo Symptom Scale (VSS), the Dizziness Handicap Index (DHI), and the Posttraumatic Post-Traumatic Disorder Checklist Scale (PCL-5) were administered online, and the interactions between the variable sets were examined using a correlational screening model. RESULTS: As a result of the structural equation model established with the observed variables, it was found that VSS total scores had a statistically significant positive effect on PCL-5 (ß1 = 0.56; p = 0.001 < 0.05). In addition, statistically significant positive high-level correlations were found between VSS and DHI (covVSS-DHI = 0.71), and a positive low level correlation with the number of days with dizziness (covVSS-number of days with dizziness = 0.34), and a positive low level correlation with frequency of days with dizziness (covVSS-frequency of days with dizziness = 0.37). A statistically significant positive low-level relationship was found between DHI and the number of days with dizziness (covDHI-number of days with dizziness = 0.34) and a positive low-level correlation between DHI and the frequency of days with dizziness (covDHI-frequency of days with dizziness = 0.29). CONCLUSION: The structural equation modeling analysis showed that post-traumatic stress disorder had a significant effect on balance and dizziness.

Stereotactic Radiosurgery in the Management of Brain Metastases: A Case-Based Radiosurgery Society Practice Guideline.

Purpose: Brain metastases are common among adult patients with solid malignancies and are increasingly being treated with stereotactic radiosurgery (SRS). As more patients with brain metastases are becoming eligible for SRS, there is a need for practical review of patient selection and treatment considerations. Methods and Materials: Two patient cases were identified to use as the foundation for a discussion of a wide and representative range of management principles: (A) SRS alone for 5 to 15 lesions and (B) a large single metastasis to be treated with pre- or postoperative SRS. Patient selection, fractionation, prescription dose, treatment technique, and dose constraints are discussed. Literature relevant to these cases is summarized to provide a framework for treatment of similar patients. Results: Treatment of brain metastases with SRS requires many considerations including optimal patient selection, fractionation selection, and plan optimization. Conclusions: Case-based practice guidelines developed by the Radiosurgery Society provide a practical guide to the common scenarios noted above affecting patients with metastatic brain tumors.

Make your choice: Angiography or periodical health examination?

Periodical health examination is one of the important factors influencing a healthy lifestyle. Patients undergoing routine physical examination in primary care are included in the scope of preventive medical services, which is the most basic principle of primary care. Identifying the risk factors enables individuals to adopt healthier lifestyle practices. In our study, we examined the correlation between patients undergoing coronary angiography for suspected coronary stenosis and the extent of primary care services they had received in their medical history, along with the severity of stenosis observed during the angiography. Patients were interviewed using a pre-structured questionnaire to gather information about their past utilization of primary healthcare services related to coronary matters and their cardiovascular (CV) risk profile as documented in their medical history. The necessary standard tests for angiography procedures were retrieved from patient records. The SYNTAX score, a tool that aids in the objective assessment of the severity of coronary artery disease (CAD), was computed and documented. This score was then compared with the history of primary care utilization. The patients' utilization of services from the Primary Healthcare Center (PHC) was evaluated using a scoring system, with an average score of 29.27 ±â€…11.27 out of 100 points (minimum: 20; maximum: 60). The average SCORE Türkiye indicating the 10-year risk of CV events for all patients was calculated as 14.31% ±â€…8.65% (high-very high risk), while the average SYNTAX score was 15.20 ±â€…9.97. There was a positive and significant correlation found between fasting blood glucose and creatinine values with both SYNTAX score and SCORE Türkiye (respectively; R = 0.238, P = .013; R = 0.289, P = .002). Factors such as smoking and metabolic syndrome were associated with CAD severity. It important to highlight that individual recommended for angiography had a notably lower utilization of healthcare services from the PHC based on their medical histories. This circumstance has resulted in individuals who do not undergo CV event screenings at PHCs having higher SYNTAX scores, indicating more severe CAD that necessitates angiography. Conducting regular periodical health examinations at PHCs can help mitigate these statistics.

Investigation of postural sensory organization in women with and without primary dysmenorrhea in three phases of the menstrual cycle.

BACKGROUND: The effects of the menstrual cycle in women with and without primary dysmenorrhea on phase-related postural sensory organization are controversial. RESEARCH QUESTION: This study was carried out to examine postural sensory organization in three phases of the menstrual cycle in women with and without primary dysmenorrhea and to evaluate whether there is a difference between women with/without primary dysmenorrhea in this regard. METHODS: Women aged 18-30 years were divided into two groups as primary dysmenorrhea group (PDG, n = 14) and control group (CG, n = 15). Computerized dynamic posturography were applied to the participants on the follicular, ovulation, and luteal phases of the menstrual cycle. Outcome measures were antero-posterior and medio-lateral Sensory Organization Test (SOT-somatosensory, vestibular and visual scores) and Limits of Stability test (LoS). The findings obtained were analyzed with the two-factor ANOVA, paired samples t test, and independent samples t test. RESULTS: In the PDG, follicular phase antero-posterior somatosensory scores were lower compared to luteal phase (p = 0.002). Follicular phase antero-posterior and medio-lateral vestibular scores were lower than ovulation (p = 0.003, p = 0.004, respectively) and luteal (p = 0.005, p = 0.001, respectively) phases. Follicular phase LoS scores were lower than ovulation (p = 0.001) and luteal (p = 0.002) phases. In the CG, ovulation phase antero-posterior somatosensory scores were lower than follicular phase (p = 0.003). Follicular phase LoS scores were lower than ovulation phase (p = 0.002). The PDG had lower follicular phase antero-posterior somatosensory (p = 0.019), vestibular (p = 0.031), and medio-lateral somatosensory (p = 0.019) scores than those of the CG. The PDG had lower luteal phase antero-posterior somatosensory scores than those of the CG (p = 0.029). The PDG showed lower follicular phase LoS scores than those of the CG (p = 0.009). SIGNIFICANCE: This study revealed that primary dysmenorrhea impairs postural sensory organization. Decreased sensory organization may predispose women to injury. The risk of injury should be investigated and necessary precautions should be taken.

The refractory secondary hyperparathyroidism presenting with retro-orbital brown tumor: a case report.

BACKGROUND: Tertiary hyperparathyroidism describes the autonomous and excessive secretion of parathyroid hormone (PTH) by the parathyroid glands after longstanding secondary hyperparathyroidism in chronic kidney disease. Brown tumors are a sign of uncontrolled hyperparathyroidism. In this case, we have reported a refractory and destructive hyperparathyroidism storm. Also, it presented with atypical onset and unexpected adenoma location. CASE PRESENTATION: A 37-year-old man was diagnosed with end-stage kidney disease 22 years ago. He has been undergoing dialysis treatment since that time. Recently, he was admitted to the ophthalmology department due to the unilateral anterior bulging of the right eye and drooping of the eyelid. Magnetic resonance imaging exhibited an extraconal mass lesion located in the right orbital posterior superolateral position. Computerized tomography scans considered expansile bone lesion with peripheral calcification and originating from the sphenoid wing. The bone mass lesion was resected via craniotomy due to the compressive effect. The pathological findings were consistent with brown tumors. Plasma intact PTH level was 4557 pg/mL. The patient informed that he underwent parathyroidectomy and two leg fractures operation in a medical query. Parathyroid scintigraphy determined three distinct foci consistent with adenomas and one of them was in mediastenum. Second parathyroidectomy was recommended to the patient but the patient refused surgery. Despite his medication and dialysis regimen being revised, PTH levels were maintained at higher levels in follow-up. CONCLUSIONS: We presented a hyperparathyroidism case that was resistant to all treatments and exhibited all the severe complications in a long-term dialysis patient. Furthermore, this case has revealed the importance and difficulty of secondary hyperparathyroidism management.

Involvement of small leucine-rich proteoglycans and telocytes in thin and thick human endometrium: immunohistochemical and ultrastructural examination.

Thin endometrium, defined as an endometrial thickness of less than 7 mm during the late follicular phase, is a common cause of frequent cancelation of embryo transfers or recurrent implantation failure during assisted reproductive treatment. Small proteoglycans regulate intracellular signaling cascades by bridging other matrix molecules and tissue elements, affecting cell proliferation, adhesion, migration, and cytokine concentration. The aim of the study is to investigate the role of small leucine-rich proteoglycans in the pathogenesis of thin and thick human endometrium and their differences from normal endometrium in terms of fine structure properties. Normal, thin, and thick endometrial samples were collected, and small leucine-rich proteoglycans (SLRPs), decorin, lumican, biglycan, and fibromodulin immunoreactivities were comparatively analyzed immunohistochemically. The data were compared statistically. Moreover, ultrastructural differences among the groups were evaluated by transmission electron microscopy. The immunoreactivities of decorin, lumican, and biglycan were higher in the thin endometrial glandular epithelium and stroma compared to the normal and thick endometrium (p < .001). Fibromodulin immunoreactivity was also higher in the thin endometrial glandular epithelium than in the normal and thick endometrium (p < .001). However, there was no statistical difference in the stroma among the groups. Ultrastructural features were not profoundly different among cases. Telocytes, however, were not seen in the thin endometrium in contrast to normal and thin endometrial tissues. These findings suggest a possible role of changes in proteoglycan levels in the pathogenesis of thin endometrium.

Enhancing Primary Care for Nursing Home Patients with an Artificial Intelligence-Aided Rational Drug Use Web Assistant.

Polypharmacy can result in drug-drug interactions, severe side-effects, drug-disease interactions, inappropriate medication use in the elderly, and escalating costs. This study aims to evaluate nursing home residents' medication regimens using a rational drug use web assistant developed by researchers to mitigate unnecessary medication usage. This analytical, cross-sectional study included data from nursing home residents recently recorded in a training family health center. Sociodemographic information, medical conditions, and prescribed medications of all patients in the nursing home (n = 99) were documented. Medications were assessed using an artificial intelligence-aided rational drug use web assistant. Instances of inappropriate drug use and calculations of contraindicated drug costs were also recorded. The study revealed that 88.9% (n = 88) of patients experienced polypharmacy, with a mean value of 6.96 ± 2.94 drugs per patient. Potential risky drug-drug interactions were present in 89.9% (n = 89) of patients, contraindicated drug-drug interactions in 20.2% (n = 20), and potentially inappropriate drug use in 86.9% (n = 86). Plans to discontinue 83 medications were estimated to reduce total direct medication costs by 9.1% per month. After the assessment with the rational drug use web assistant, the number of drugs that patients needed to use and polypharmacy decreased significantly. This study concludes that the rational drug use web assistant application, which is more cost-effective than the traditional manual method, assisted by artificial intelligence, and integrated into healthcare services, may offer substantial benefits to family physicians and their geriatric patients.

How Perceptions of Parents' Parenting Behaviors Pave the Way to Somatic Symptoms: The Mediating Role of Emotion Regulation Among Adults.

The purpose of this study was to investigate adult participants' reflections on their parents' parenting behaviors during childhood (parental overprotection and parental rejection), and their current emotion-regulation strategies and somatic symptoms. The study consisted of 627 participants and Somatization subscale of the Symptom Checklist-90-Revised, Difficulties in Emotion Regulation Scale and Short EMBU Children Form were given to the participants. Four different multiple mediation analyses were conducted to test mediator roles of emotion regulation difficulties between perceptions of the parenting behaviors (parental overprotection and rejection) and somatic symptoms among adults. Participants' lack of goals and lack of strategies while dealing with negative emotions mediated the relationship between mother/father rejection and somatic symptoms. However, only participants' lack of strategies while dealing with negative emotions mediated the relationship between mother/father overprotection and somatic symptoms. As a clinical implication, problem-focused coping strategies may assist adults with somatic symptoms. Also, mental health practitioners may focus on perceptions of overprotective and rejecting parental behaviors while formulizing somatic symptoms of the adult patients. Findings, strengths and limitations of this study were discussed in the light of the literature.

An unusual form of kidney injury without glomerulonephritis in microscopic polyangiitis: a case report.

BACKGROUND: Microscopic polyangiitis (MPA), a kind of antineutrophil cytoplasmic autoantibody associated vasculitis (AAV), predominantly affects small-sized vessels. MPA is a significant cause of the pulmonary-renal syndrome. Pauci-immune necrotizing and crescentic glomerulonephritis is the typical renal histological feature of AAV. Tubulointerstitial lesions may occur and mostly form with inflammatory cell infiltration in the interstitium. However, a few cases reported only tubulointerstitial involvement without glomerular lesions in patients with MPA. CASE PRESENTATION: We present an MPA case, a 70-year-old male patient diagnosed with acute kidney injury accompanying the dialysis requirement. Only acute tubulointerstitial nephritis was revealed in kidney biopsy without evidence of glomerular injury. Also, interstitial pulmonary fibrosis was determined on computerized tomography, and myeloperoxidase antineutrophil cytoplasmic autoantibody was positive. Consequently, we have considered the main diagnosis as MPA. We did not prefer a standard tubulointerstitial nephritis treatment regimen due to the presence of life-threatening systemic vasculitis. Treatment was established like crescentic glomerulonephritis. Induction therapy consisted of pulse steroid, cyclophosphamide, and plasmapheresis. Unfortunately, severe SARS-CoV-2 infection caused death during induction therapy in this case. CONCLUSIONS: The lack of glomerular injury and solely interstitial inflammation is atypical regarding AAV involvement in the kidney. This diversity might be initially considered as only a simple histological elaboration. However, it is a significant entity for guiding the treatment of AAV.

Investigation of apoptotic and antiproliferative effects of Turkish natural tetraploids Trifolium pratense L. extract on C6 glioblastoma cells via light and electron microscopy.

Glioblastoma (GBM) is the most common type of primary brain tumors in adults, characterized by its ability to proliferate rapidly and its tendency to aggressively and strongly invaded the surrounding brain tissue. The standard treatment approach of GBM is surgical resection followed by simultaneous chemotherapy and radiation. However, a significant number of GBM cases develop resistance to currently used chemotherapeutic drugs. Therefore, there is a need for the development of new chemotherapeutic agents. Trifoliumpratense L. is an endemic plant containing various isoflavones such as biochanin A, genistein, daidzein, and formononetin in high concentrations, and it has been shown in various studies that these molecules can function as anticancer agents. The present study was designed to determine the effect of the possible anticarcinogenic effects of the Trifolium pratense L. which grown in our country and to obtain new treatment approaches alternative to the classical treatment protocols applied in the treatment of GBM. C6 glioblastoma cells were cultured with Trifolium pratense L. Cell proliferation, apoptotic cell morphology, and cell structure were evaluated with CCK8, Annexin V, cytochrome c, CD117, and Betatubulin labeling, respectively. And also, investigated effects of this Turkish tetraploid on GBM by TEM. Decreased cell proliferation and increased number of apoptotic cells were observed depending on the increasing doses of Trifolium pratense L. In addition, intense morphological changes were detected depending on increasing doses. In this context, we believe that the plant Trifolium pratense L., may be a new alternative and adjuvant agent for the treatment of GBM.

A novel biosensor for ultrasensitive detection of fungal genes.

Fungal infections are a rapidly increasing public health problem due to their high morbidity and mortality rates, especially in populations with compromised immune systems. Rapid and accurate diagnosis of these diseases is, therefore, necessary to improve the prognosis of afflicted patients. Unfortunately, current clinical chemistry practice relies on lengthy culturing methods that are insufficient to meet the fast turnaround requirements. Here we present a cost-effective and robust nucleic acid sensor that can identify the presence of histoplasmosis causing fungal genes, in whole blood or bronchoalveolar lavage (BAL) samples, far earlier than current methods. Our novel assay involves the hybridization of target gene sequences with immobilized nucleic acid probes, allowing direct, label-free detection of Hcp100, CBP1, and M antigen genes through electrochemical analysis. The resultant current is attributed to the presence of fungal targets in the sample solution. The assay provides ultra-sensitive detection of DNA molecules with a limit of detection (LOD) values down to 100 aM, sufficient to meet the clinical diagnostic need. In addition, the turnaround time for the sample to result is less than 90 min compared to the current clinical procedure's turnaround time of 3-4 weeks.

Bacterial hydrogen sulfide drives cryptic redox chemistry in gut microbial communities.

Microbial biochemistry contributes to a dynamic environment in the gut. Yet, how bacterial metabolites such as hydrogen sulfide (H2S) mechanistically alter the gut chemical landscape is poorly understood. Here we show that microbially generated H2S drives the abiotic reduction of azo (R-N = N-R') xenobiotics, which are commonly found in Western food dyes and drugs. This nonenzymatic reduction of azo compounds is demonstrated in Escherichia coli cultures, in human faecal microbial communities and in vivo in male mice. Changing dietary levels of the H2S xenobiotic redox partner Red 40 transiently decreases mouse faecal sulfide levels, demonstrating that a xenobiotic can attenuate sulfide concentration and alleviate H2S accumulation in vivo. Cryptic H2S redox chemistry thus can modulate sulfur homeostasis, alter the chemical landscape in the gut and contribute to azo food dye and drug metabolism. Interactions between chemicals derived from microbial communities may be a key feature shaping metabolism in the gut.

Erythema Multiforme Associated With Phenytoin and Cranial RadiationTherapy (EMPACT) Syndrome Associated With Cranial Radiotherapy and Levetiracetam: A Case Report.

Cranial radiotherapy (RT) is an irradiated way to treat patients with brain malignancies. Seizure is the most common symptom. Due to the frequency of seizure risk, cranial RT is usually received concomitant with previously initiated antiepileptic drugs (AED). This combination can lead to erythema multiforme (EM) like serious skin reactions starting from the irradiated port site and spreading to whole cutaneous surfaces and mucosal membranes. This clinical entity is named after as an acronym of components which are Erythema Multiforme associated with Phenytoin And Cranial RadiationTherapy as EMPACT syndrome. Most cases of EMPACT syndrome are reported with phenytoin in the literature, but there are no reported cases with levetiracetam to the best of our knowledge in the literature. Here, we report a 62-year-old male with glioblastoma, presented with severe conjunctivitis, extensive bleeding erosions in his oral mucosa and erythematous macular eruptions on the right temporoparietal port region of the scalp, and EM-like generalized lesions involved neck, chest, back, and arms following the end of his cranial RT. He was diagnosed with EMPACT syndrome, related to using levetiracetam concomitant with cranial RT. Early diagnosis is crucial for the complete response of treatment. Physicians should be alert to possible skin and mucosal reactions of patients under levetiracetam treatment, especially co-existing use of cranial RT.

Does interpersonal sensitivity and paranoid ideation predict nomophobia: an analysis with a young adult sample.

Nomophobia has been studied extensively due to its negative effects on human health and psychology. In terms of clinical psychology, nomophobia has been linked consistently to depression and anxiety. Studies also investigated whether it is a dependency, an impulse control problem, an obsession or a phobia; however, no clear clinical representation was confirmed. Although it was proposed to be added as an official diagnosis to DSM-5, these attempts were inconclusive. In this study, nomophobia was examined clinically by SCL-90 factors. A hierarchical regression analysis was performed by controlling anxiety, depression, phobia and obsessions by putting them in the first step. At the next step, paranoid ideation was entered while interpersonal sensitivity was introduced at the last step. The variables were assigned according to the steps according to their connections confirmed by the literature, the correlation coefficients and ß weights obtained in the current study. The hierarchical regression analysis confirmed that after controlling anxiety, depression, phobia and obsessions, nomophobia is explained by interpersonal sensitivity. Paranoid ideation is also an important variable in step 2, but it lost its significance in the last step. Nevertheless, it was thought that what makes people sensitive to interpersonal issues is a kind of fear of missing out others' experiences (FoMO) which is related to nomophobia. This fear of missing out might prepare people to constantly check on mobile phones thinking paranoid about what they might have been missing or deprived of. Clinical implications and limitations were discussed.

Musculoskeletal system disorders among surgical nurses related to the health industry in northwestern Turkey: a cross-sectional study.

Objectives. Nurses may encounter musculoskeletal disorders (MSDs) and pain episodes stemming from regular exposure to health industry risk factors. This study aimed to determine the prevalence of MSDs and associated factors among Turkish surgical nurses. Methods. A cross-sectional design using self-administered questionnaire surveys was employed with 169 surgical nurses. The survey included an individual data questionnaire and the Nordic musculoskeletal questionnaire - extended (NMQ-E). Results. In total, 88.8% of the surgical nurses had musculoskeletal system disorders, and most experienced these problems related to the health industry. The interventions causing physical strain in the participants were identified as constant standing up, patient care, carrying heavy loads, sudden movements, patient transfer and pulling-pushing practices. The nurses used coping methods including walking, exercising, receiving physiotherapist support, pilates and yoga. The most frequently encountered problems were in the back region. A significant relationship was found between musculoskeletal system problems and the clinic of work, years of work, age and gender (p < 0.05). Conclusions. Nurses experience musculoskeletal problems related to the health industry. It is crucial to determine the real causes of musculoskeletal problems and take appropriate preventive measures to improve workplace ergonomics.

Approaches and awareness of family physicians on diabetes management during Ramadan.

AIM: This study aimed to determine the approaches of family physicians in Turkey towards the fasting of diabetic patients and whether they used international treatment guidelines when making recommendations. In addition, this study also aimed to increase the awareness of family physicians about this issue before Ramadan, which is a month of fasting. MATERIAL AND METHOD: The study herein comprised cross-sectional, observational research. Before Ramadan 2018, a structured questionnaire form, which was unique to this study, was prepared based on the guidelines of the International Diabetes Federation (IDF) and the American Diabetes Association (ADA), through platforms where family physicians gather via social media and mail groups, and sent to family physicians in Turkey via a link using an electronic questionnaire preparation and application programme. Moreover, the total knowledge level, attitude, and approach scores were calculated from the questions prepared from the relevant guidelines. RESULTS: Participating in the survey were 262 family physicians. Only 22% of the family physicians stated that they were aware of the international guidelines for Ramadan and diabetes management, and only 10% said that they had read them. The mean knowledge level, attitude, and approach scores were determined to be lower than expected, and a significant difference was found between the scores and academic titles. CONCLUSION: The lack of international guidelines on the subject, and of knowledge and experience about Diabetes Mellitus (DM) patient management during the month of fasting, stood out as the biggest problems. This study revealed that the awareness and competence of family physicians in disease management should be increased, in addition to that of fasting before, during, and after Ramadan in patients with DM, which has increasing prevalence in Turkey.

Victimology from clinical psychology perspective: psychological assessment of victims and professionals working with victims.

Victimology concerns victims of various traumas from accidents, disasters, assaults to wars. Survivors of trauma are also an area in clinical psychology since it is interested in the assessment and diagnosis of psychopathology and psychotherapy. Stress and mental health are intertwined; increased stress results in difficulties in feeling, thinking and behaving. The stress symptoms are an intrusion, avoidance, negative cognitions and mood, and arousal and reactivity. A trauma survivor might develop post-traumatic stress disorder. Healing trauma is so comprehensive that many professionals work from different aspects. From attorneys to mental health workers, many professionals deal with the aftereffects of trauma. Engaging with details of the trauma endangers not only the victims but also the professionals working with the victims. These professionals end up having psychological effects such as secondary trauma, vicarious trauma, compassion fatigue, countertransference and occupational burnout. Trauma has serious effects on its victims but not all effects are negative and paralyzing. Trauma victims might change their priorities in a way that they report more personal control over their life. This phenomenon is called posttraumatic growth. The paper aims to collaborate victimology with clinical psychology by highlighting psychopathology and psychological assessment.

Family planning practices and opinions on population growth of family planning healthcare providers in Turkey.

The purpose of this study was to investigate the opinions of health professionals (HPs) who provide family planning counselling (FPC) within the scope of primary health care services since they are perceived as role models by the society. The number of HPs providing family planning counselling in primary health services in Turkey was 43,000 and 40,000 of these individuals were invited to participate in this observational, cross-sectional study via e-mail and social media. There were 740 responders and all were included in the study. Physicians providing FPC within the scope of primary health care services consisted of 45.1% of the responders and the remaining were nurses. Among all HPs, 59.7% had insufficient awareness regarding Turkey's population growth. Most of the HPs (52.4%) believed that the ideal number of children was 2 or less. The abortion rate was 9.1% in all pregnancies of HPs. The rate of caesarean section was 56% in all live births. According to responses, 75.6% of all pregnancies experienced by HPs were planned. According to 42.1% of the HPs, abortion must be performed if there is a life-threatening situation for the mother or if the fetus has some abnormalities. The most common method of birth control used by married HPs between the ages of 18 and 49 was male condoms (39.9%), while the pull-out method ranked first in the general population (25.5%). It was found that HPs, who had different opinions and practices about family planning than the general population, had insufficient awareness regarding population growth. Increased awareness of demography and FPC among HPs will likely contribute to the quality of service and the general wellbeing of the population.

The role of unfolded protein response in the pathogenesis of endometriosis: contribution of peritoneal fluid.

RESEARCH QUESTION: Endoplasmic reticulum stress (ERS) is caused by the accumulation of the misfolded or unfolded proteins in the endoplasmic reticulum and induces the unfolded protein response (UPR). Peritoneal fluid is important in the pathogenesis of endometriosis. In this study, the role of UPR associated with ERS in endometriosis, and peritoneal fluid, were investigated. DESIGN: Normal, eutopic and ectopic endometrium tissues were divided into menstrual cycle phases, and endometrial stromal cells (ESC) were treated with 10-20% concentration of control peritoneal fluid and peritoneal fluid obtained from women with endometriosis for 10, 30 and 60 min, and 24 and 48 h. The UPR signalling proteins were analysed immunohistochemically and immunocytochemically. Data were compared statistically. RESULTS: p-IRE1 was increased in ectopic glandular and stromal cells in the early proliferative phase compared with normal and eutopic endometrium. p-PERK increased in ectopic glandular and stromal cells in the late proliferative phase compared with normal endometrium. ATF6 was increased in ectopic glandular epithelium compared with normal endometrium in the proliferative phases, versus eutopic endometrium in the late secretory phase. p-IRE1 and p-PERK were increased in high concentrations of ESC treated with peritoneal fluid obtained from women with endometriosis for 10, 30 and 60 min compared with controls. In ESC treated with peritoneal fluid from women with endometriosis, p-IRE1 decreased at 24-48 h compared with 30 min. CONCLUSIONS: In endometriosis, UPR pathways are activated as highly dependent on cell type and phase. Also, p-PERK and p-IRE1 increased because of exposure to high-dose peritoneal fluid from women with endometriosis in stromal cells. Our findings provide a basis for further studies searching for a potential biomarker for the diagnosis of endometriosis.